Individual provider Active NPI

Madeline Claude

  • Clinical Social Worker
  • Centerville, UT
National Provider Identifier
1053967752
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11792012-3501 Issued in UT
Practice address
520 N Market Place Dr
Centerville, UT 84014-4901
Phone
(801) 934-3373
NPI assigned
Aug 18, 2019
Last updated
Sep 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11792012-3501 UT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

520 N Market Place Dr
Centerville, UT 84014-4901

Mailing address

520 N Market Place Dr
Centerville, UT 84014-4901
Phone (801) 934-3373

Other practice location 1

750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221006000499 UT Practitioner - Clinical Social Worker 4082090527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Utah School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Davis Psychological ServicesGroup PAC ID 0446511927, 17 clinicians

Practice addresses (Care Compare)

520 N Market Place Dr
Suite 200
Centerville, UT 84014-4904
Phone (801) 934-3373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11792012-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Davis Psychological Services CurrentSince Sep 1, 2022 Accepting new patients
Neurorev PLLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

469 Medical Dr
Ste 200
Bountiful, UT 84010
Phone (801) 292-5812

520 N Market Place Dr
Ste 200
Centerville, UT 84014
Phone (801) 243-6822

1544 Woodland Park Dr
Ste 320
Layton, UT 84041
Phone (801) 556-4751

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1053967752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N MARKET PLACE DR",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840144901",
            "telephone_number": "801-934-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N MARKET PLACE DR",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840144901",
            "telephone_number": "801-934-3373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 N Freedom Blvd",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846011677",
            "country_code": "US",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAUDE",
        "first_name": "MADELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-18",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11792012-3501",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, UT

Sources for this page

Verify at the official NPI Registry.